It used to be that our beloved NHS was in crisis every winter. But now the NHS seems to be permanently in crisis. And every year we’re told the NHS needs ever more of our money and ever more staff. In this week’s budget it was handed another few billion which will no doubt disappear down the massive toilet of waste and profligacy that is our national healthcare service.
I realise we have had the pandemic and then seemingly endless strikes by doctors and others. But the NHS’s problems started long before the pandemic and the strikes.
Last week the Office for National Statistics (ONS) released data showing the number of staff by main work categories for each of the constituent parts of the U.K. – England, Scotland, Wales and Northern Ireland. (These figures are expressed as FTEs – full-time equivalents – so this takes account of people who may be working part-time.)
As each of the countries classes NHS employees in slightly different ways, it’s difficult to get reliable total NHS employee figures for the whole U.K. However, if we just look at the largest part of the NHS – NHS England – we can get a reasonable idea of what’s going on. Here’s a summary chart produced by the ONS:
Now let’s look at the numbers:
- The number of doctors increased by 37,467 (up 37%) from 101,137 in 2013 to 138,604 by 2023.
- The number of nurses and midwives increased by 68,063 (up 23%) from 295,163 in 2013 to 363,226 in 2023.
- The number of scientific staff increased by 42,938 (up 13%) from 123,912 in 2013 to 166,850 in 2023.
- The number of support staff increased by 125,510 (up 45%) from 279,579 in 2013 to 405,089 in 2023.
- The number of infrastructure staff increased by 62,758 (up 41%) from 152,437 in 2013 to 215,195 in 2023.
- The number of ambulance staff increased by just 1,721 (up 10%) from 17,537 in 2013 to 19,258 in 2023.
Here are just a few things you might have noticed:
- The total number of staff increased by 338,4577 (35%) from 969,765 in 2013 to 1,308,222 in 2023.
- The largest increases were in non-medical staff, with support staff shooting up by 45% and infrastructure staff rising by 41%.
- The smallest increase was in ambulance staff – up just 10%. Some people might find that slightly worrying. But don’t worry, at the same time as the number of ambulance staff has gone up by only 1,721, the number of DIE (diversity, inclusion and equality) managers has shot up from virtually none in 2013 to more than 800 now. So, if an ambulance does actually manage to reach you before you croak it, the ambulance workers will no doubt be wonderfully racially and gender diverse, which is what you absolutely want from an ambulance service.
We’re constantly told that one reason the NHS is collapsing is a rising population. But the population of England only rose by around 7% between 2013 and 2023. At the same time the number of doctors rose by 37% and the number of nurses and midwives rose by 23%. In Scotland the number of NHS staff rose by about 20% while the population only rose by around 2.7%. In Wales NHS staff numbers increased by 32% while the population only went up by 2%. And in Northern Ireland, NHS staff numbers rose by 20% while the population only increased by 4%. So the excuse of the NHS needing many more staff to cope with a rapidly rising population doesn’t hold water.
Another reason given for the NHS’s constant state of disintegration is that the U.K. population is getting older. Over the period from 2013 to 2023 the mean age of the U.K.’s population rose from 39 years to about 41.5 years – a rise of 6.4%. So this excuse seems pretty flimsy, too.
And then there’s the usual bleating that we don’t spend as much on health as other developed countries. It’s true that we spend less per capita than several European countries. But U.K. health spending per capita is on the OECD average:
While there is some truth in the claim that some other countries spend much more per capita on health, many spend less and we don’t hear about their health systems collapsing like our beloved NHS. So levels of spending and staffing cannot be the only reasons for the utter chaos in our health service.
A better explanation for the NHS’s floundering failure can possibly be seen in the massive increase in non-medical staff – an increase in support staff in the NHS England of an astonishing 45% and in infrastructure staff of 41%. It’s not obvious why a population which has increased by just 7% between 2013 and 2023 and which has got very slightly older should require such a huge rise in non-medical NHS staff. And there has been a 22% increase in NHS administrative staff in Scotland, Wales and Northern Ireland yet the population served by the NHS there has only gone up by around 2.7%.
But you can look at the numbers, think about your own, your friends’ and your families’ experiences of our pitiful NHS and make up your own minds about the competence of NHS management and the fact that our NHS seems to be doing ever less with ever more money and ever more staff.
David Craig is the author of There is No Climate Crisis, available as an e-book or paperback from Amazon.
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Let people chose their health care providers and their insurance companies.
But that will never happen because that would mean certain people losing power and influence. And they have the motivation and resources to make sure they don’t lose their grip.
That’s just how it is.
Same with schools. Why shouldn’t parents be able to chose their school? Because the people who supply the service have no interest whatsoever in submitting themselves to any form of market discipline.
My wife worked as a secretary within the Clinical Psychology Department of our local NHS Trust Hospital. Clinical Psychology is a function which is “nice to have”. The staff tend to be young and well-meaning, and they do a lot of good work helping the terminally ill and people with various life-changing conditions come to terms with their situation.
However, they cannot claim to address any of the major issues facing the NHS, e.g. reducing waiting lists for elective surgery or clearing the queues from A&E, and it’s an absolute mystery why the hospital chose to double to size of this department when there were more urgent issues to be addressed.
It’s hard to escape the conclusion that someone in the Trust’s HQ had aways wanted a thriving Clinical Psychology function and used the recent crises to provide the funding,regardless of what the government may have intended. I’m assuming that the increased numbers of Clinical Psychologists are part of the 45% increase in “Support Staff”?
Got to employ all those gullible youngsters who have forked out £40K + to get a degree in Psychology or Social Sciences somewhere.
I agree fully that the NHS is a failed system. Many NHS workers that I have spoken to would also agree with this (without making their views public). Maybe the system isn’t supposed to work as we would like. The largest beneficiaries appear to be the pharmaceutical companies that charge extortionate amounts for their drugs especially if they are on patent. And who pays for this? We do – the taxpayers – whether we choose to or not. I am totally convinced this system isn’t about your health. If it were, there would be more emphasis on diet and other preventative measures. But no, the emphasis is on medication even though practically every medical intervention has a side effect and is likely to lead to more medication. The length of prescriptions get longer. I could weep at the ‘quality’ of care the NHS provides. I hope and pray that we get to a stage where the system becomes more about care and no longer about money (as the NHS has become)
It isn’t failed, because it could never succeed. Socialist collectives never do.
It serves to meet political/ideological objectives.
It is a non-contestable monopoly which cannot go bankrupt, and it is not part of a price system so no way to know how its consumers value it compared to other options.
It is a cost centre, makes no revenue so it is impossible to gauge whether the value of its output as perceived by paying consumers exceeds the value of its input.
Taken together there is no incentive for fiscal prudence, or increased labour productivity and efficiency, or any way to measure either.
Since it is funded by annually adjusted budgets, and staff are rewarding by length of service and grade not merit and industry, there is a perverse incentive to do less with more funding to justify increased funding next budget round.
Apart from that it’s ace – so I wonder why people keep asking the same idiot question over and over again – why does the NHS not perform despite more and more cash being slung at it? It’s like asking why don’t elephants fly? Because they cannot – it’s in their design.
My wife was recently in hospital for a few days, a consequence of a medication related problem that led to a broken arm.
While I was in there visiting I witnessed a ceiling light bulb being changed. There were 3 male technicians, one to erect and climb the step ladder after placing red barriers around it and 2 others to hold the step ladder while he climbed it. I noticed this particularly because they also set one of the 2 bed-sized lifts to ‘service only’ for the 15 or so minutes it took to ascend from the ground floor to the 5th and return.
Surely this was a 1 person job.
It is illuminating, nay sadly amusing, that the world’s biggest Healthcare Spenders, aka the USA have one of the worst health outcomes in the world.
Why is this?
Spoiler alert – it might have something to do with the millions of vaccines they’ve pumped into kids arms since the 1980’s. 60+ and counting is it now?
A lot of sheep have awoken as to the dangers of mRNA gene therapies, and are questioning the safe lol, traditional jabs.
The mRNA vaccines seem to have made the NHS staff more generally “vaccine hesitant” too; the rate of flu vaccination in frontline NHS healthcare workers has dropped from 74% before COVID to 43% in the most recent season. https://makismd.substack.com/p/covid-19-vaccine-uptake-uk-healthcare
If my experience is anything to go by it’s way less than 50%.
The plus 50% take up for even the traditional vaccines amongst NHS “workers” mainly comprise the management class, who know the square root of F. all about immunology/vaccinology.
Believe me the take up of the genetic therapies mRNA was way less than 50%.amongst those who actually work on the so called “Front Line” in the NHS.
There’s a very good reason why that bastard Hancock pulled mandating jabs for the NHS – there would have been sweet F.all left of it – and he knew that.
Unfortunately he was able to succeed with the poor care workers – who by the way are the essential backstop of our wondefrul NHS…
I think the issue is protocol-based medicine, rather than personalised medicine.
this leads to inefficiency and waste.
One example of a daft protocol:
GP knows the patient, who has a worsening hip problem.
GP decides hip replacement will be needed and wants to refer patient to orthopaedic surgeon….but no…protocol says GP needs to refer to specialist physiotherapist for assessment…
Not sure if this is a National protocol, but it is the protocol in my area.
Two examples from my own circle of acquaintances:
a) 78 yr old woman; lives alone; multiple, un-diagnosed problems over several months (almost certainly vaccine-damage) and told by her GP she needed to go to A & E. Called for an ambulance … and was told she wasn’t a priority since her symptoms didn’t indicate a heart attack or stroke, so could be waiting for up to 8 hours. I took her; she could barely walk/stand and was admitted 6 hours later.
Loads of tests run; couldn’t find anything wrong so sent her home a few days later with nothing resolved.
b) friend, mid-60s; every time I see her, roughly once a fortnight, she or her husband (both overweight and diabetic) have had yet another appointment with their GP ….. multiple reasons, none life-threatening …. but they run to the GP for the slightest complaint.
I am disgusted by (a) and I object to paying for (b) to exploit the “free” health service.
The diversity types represent 50% of the increase in ambulance staff. Given the % on sick leave, probably less ambulance staff available.
It doesn’t take a genius to see some of the bad trends in this data.